How much rates vary
Facilitymedian $380 · 10th to 90th $105 to $2,754Professionalmedian $158 · 10th to 90th $117 to $324
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $154.88 Median $288.40 Typical High $8,317.64 | Facility | None | $154.88 | $288.40 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $204.17 Typical High $346.74 | Professional | None | $123.03 | $204.17 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $177.83 | Professional | None | $114.82 | $138.04 | $177.83 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $691.83 | Professional | None | $128.82 | $144.54 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $1,230.27 | Facility | None | $50.12 | $50.12 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $316.23 | Professional | None | $123.03 | $199.53 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $309.03 | Professional | None | $173.78 | $251.19 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $323.59 | Professional | None | $263.03 | $323.59 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $199.53 Typical High $338.84 | Facility | None | $123.03 | $199.53 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Sentara Setting Facility Modifier None Typical Low $102.33 Median $302.00 Typical High $2,454.71 | Facility | None | $102.33 | $302.00 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $147.91 Median $275.42 Typical High $954.99 | Professional | None | $147.91 | $275.42 | $954.99 |
United Setting Facility Modifier None Typical Low $100.00 Median $645.65 Typical High $2,041.74 | Facility | None | $100.00 | $645.65 | $2,041.74 |
United Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $338.84 | Professional | None | $100.00 | $181.97 | $338.84 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $81.28 Typical High $131.83 | Professional | 52 · Reduced service | $61.66 | $81.28 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $32.36 Typical High $53.70 | Professional | 53 · Discontinued | $24.55 | $32.36 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $123.03 Typical High $199.53 | Professional | 54 · Surgery only | $91.20 | $123.03 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $24.55 Typical High $39.81 | Professional | 55 · Aftercare only | $18.62 | $24.55 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $16.22 Typical High $26.92 | Professional | 56 · Pre-op care only | $12.30 | $16.22 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $114.82 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $85.11 | $114.82 | $186.21 |
Where Virginia sits
The same service costs 4.5 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Virginia· 45th of 51
$166
AK $501KY $112
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.